COLONIAL FAMILY PRACTICE, LLC (NPI# 1770908261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770908261 |
| Entity Type | Organization |
| Organization Name | COLONIAL FAMILY PRACTICE, LLC |
| Other Organization Name | CFP FOREST ACRES 101 |
| Practice Address |
4700 Forest Dr Suite 101 Columbia SC 29206 |
| Mailing Address |
325 Broad St Ste 100 Sumter SC 29150-4167 |
| Practice Telephone | 8032561511 |
| Practice Fax Number | 8032567333 |
| Mailing Telephone | 8037735227 |
| Mailing Fax Number | 8037735227 |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2019-10-02 |
| Authorized Official Name | DAVID GLENN WHALEY (PARTNER) |
| Authorized Official Telephone | 8037735227 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | SC | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 207Q00000X | Family Medicine | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP 3564 | 05 |
| Other Name | Type Code |
|---|---|
| CFP Forest Acres 101 | Other Name - Individual/Organization |
| Colonial Family Practice Columbia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912541814 | Colonial Family Practice, LLC | Emergency Medicine | 327 Broad St, Sumter, SC 29150-4152 | 2019-11-04 |
| 1225687338 | Colonial Family Practice, LLC | Internal Medicine | 674 W Liberty St, Sumter, SC 29150-4882 | 2019-09-11 |
| 1366994824 | Colonial Family Practice, LLC | Physician Assistant | 3750 Savannah Hwy Ste I, Johns Island, SC 29455-7909 | 2016-11-01 |
| 1821383068 | Colonial Family Practice, LLC | Clinic/Center | 3044 Highway 17 Byp N Ste B, Mt Pleasant, SC 29466-9315 | 2011-06-16 |
| 1033402599 | Colonial Family Practice, LLC | Physician Assistant | 1124 Little St, Camden, SC 29020-3613 | 2011-05-17 |
| 1144534694 | Colonial Family Practice, LLC | Family Medicine | 3930 Devine St Ste B, Columbia, SC 29205-2804 | 2010-07-27 |
| 1851547640 | Colonial Family Practice, LLC | Counselor | 742 W Liberty St, Sumter, SC 29150-4746 | 2008-08-12 |
| 1518074640 | Colonial Family Practice, LLC | Counselor | 325 Broad St. Ste 100, Sumter, SC 29150-4167 | 2006-08-24 |
| 1598313827 | Colonial Family Practice, LLC | Nurse Practitioner | 26 Wesmark Ct, Sumter, SC 29150-1996 | 2019-08-29 |
| 1689194342 | Colonial Family Practice, LLC | Family Medicine | 1727 Village Park Dr, Orangeburg, SC 29118-2475 | 2017-06-23 |
| Street Address |
4700 FOREST DR SUITE 101 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295791184 | Winston B Morris | Family Medicine | 4700 Forest Dr, Suite 101, Columbia, SC 29206-3119 | 2006-04-21 |
| 1902229214 | Colonial Family Practice & Ambulatory Care Center | Emergency Medicine | 4700 Forest Dr, Columbia, SC 29206 | 2014-01-23 |
| 1164843041 | Kilgore Group, Inc. | Case Management | 4700 Forest Dr, Suite 200, Columbia, SC 29206-3119 | 2013-12-19 |
| 1558526434 | C D Guignard LLC | Counselor | 4700 Forest Dr, Suite 202, Columbia, SC 29206-3119 | 2008-07-21 |
| 1992911176 | Claudia Dickinson Guignard | Counselor | 4700 Forest Dr, Columbia, SC 29206-3119 | 2007-05-15 |
| 1750482824 | Jill Carter Lewis | Nurse Practitioner | 4700 Forest Dr, Columbia, SC 29206-3119 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710403720 | Twila Wilson | Adult Companion | 5741 D Imboden Street, Columbia, SC 29206 | 2017-08-21 |
| 1164978961 | Uri Reisman | Social Worker | 3730 Rockbridge Rd, Columbia, SC 29206 | 2016-08-31 |
| 1902237621 | Ronald Patrick Pellicer | Counselor | 6941 N Trenholm Rd Ste F102, Columbia, SC 29206 | 2013-12-05 |
| 1316376791 | Laraine Kim Jenkins | Counselor | 5211 Trenholm Rd, Suite B, Columbia, SC 29206 | 2013-11-05 |
| 1437409802 | Charles B Roman IIi | Pharmacist | 4711-5 Forest Drive, Columbia, SC 29206 | 2012-09-13 |
| 1306129879 | Rickey Gene Ayers | Counselor | 1800 Forest Drive, C, Columbia, SC 29206 | 2011-09-21 |
| 1285924316 | Lexington County Health Services District, Inc. | Internal Medicine | 4540 Trenholm Road, Columbia, SC 29206 | 2011-04-11 |
| 1144547860 | Alicia K. Harvey | Counselor | 5115 Forest Plaza Suite D, The Art and Play Therapy Center of S.c., Columbia, SC 29206 | 2010-04-21 |
| 1669703880 | Crystal Coleman | Occupational Therapist | 5234 Circle Dr, Columbia, SC 29206 | 2010-01-28 |
| 1689896938 | Carolina Dental Associates, P.a. | Dentist | 5101 Forest Drive, Columbia, SC 29206 | 2007-05-03 |
| Find all providers in zip 29206 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1457977563 | Jenny Tatiana Gonzalez Guzman | Family Medicine | Prisma Health Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-24 |
| 1942825500 | Jarvis Jamal Johnson | Family Medicine | Prisma Health Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-10 |
| 1386268183 | Nicolas Anthony Limogiannis | Family Medicine | Prisma Health Medical Group Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-08 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1558919852 | Synergos Medical, LLC | Family Medicine | 1703 Oak Cliff Pl, Columbia, MO 65203-4719 | 2019-08-29 |
| 1972156982 | Maury Regional Medical Group, Inc | Family Medicine | 2478 Nashville Hwy Ste A, Columbia, TN 38401-0634 | 2019-07-18 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.